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RNFA Program
The only RN First Assistant training on www.AORN.org
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Online Program includes the Day SutureStarXpress
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P L A N N I N G F O R Y O U R F U T U R E
Why should experienced perioperative
nurses choose this RNFA Program
At three in the morning, in the middle of a complex surgery, a surgeon wants a highly
skilled and competent RNFA graduate, not an unprepared or unpracticed student.
Mastery of surgical skills is the ultimate measure of a successful RNFA. Unfortunately, if the RNFA program
you choose doesn’t give you adequate hands-on surgical skills training, you could be stuck in the student
mode for the rest of your career. The National Institute of First Assisting, Inc. (NIFA) recognized this problem
long ago and developed training programs through collaborations with colleges throughout the country that
raised the bar and level of training.
Whether your goal is to be a self-employed, surgeon-employed, or facility-employed RNFA, you don’t want to
finish a program only to end up with entry-level results. Your success tomorrow will be commensurate with
your training today. When looking into a program, ask how many hours of hands-on lab it offers, and
if it includes performing entire surgeries Or, if this skills training is deferred to your clinical preceptor in the
surgical setting If the answer is the latter, consider the New England Journal of Medicine study found on
www.rnfa.org. The study shows that, in most cases, expertise in surgical skills cannot be obtained on-the-job
during your RNFA internship. With NIFA’s 34 hours of labs, our personal goal is to have you performing
like a seasoned expert before seeing your first patient as an RNFA intern.
The 3 Day SutureStarXpress Workshop
This Workshop is more than just suture and tying. You’ll be in simulated cases cut-to-close. Altogether, the
program offers you over 34 hours of hands-on training to prepare you for the dynamic role of first assistant.
We are fully staffed and committed to your success
Have you found it hard to speak to a program instructor We invite you to challenge NIFA’s unparalleled
Student Services Department. Call us anytime in between cases (Mon - Thurs.7:30 am - 5pm and
Fri. 7:30 am - 4 MST) and you will not be leaving voice mails. Instead, over 40 hrs a week, a real person
will answer your questions regarding RNFA education, right to practice, credentialing, certification
legislation and even reimbursements.
Online Program you can complete, no matter how busy you are
You can enroll over the phone anytime and immediately start the online, home-study portion of your
program and progress at your own pace. After successfully completing their designated hours of coursework,
the SutureStarXpress Workshop and 120 hours of clinical internship, most finish within 5-8 months.
No Risk, Lifetime Success Guarantee
Since 1998 we’ve offered this guarantee: This RNFA Program will teach you to master the techniques and
skills of the nation’s top RNFAs or we will retrain you Free-of-Charge.
Your choice is simple math
When it comes to choosing RNFA programs, your choice is clear. The RNFA Program with the 3 day
SutureStarXpress Workshop will offer you up to 15 times more suturing than most programs for a
comparable tuition. Join our competent and confident RN First Assistant professionals today!
“I want to thank NIFA for
opening up a whole new
world to me. I can’t say
enough about your program
and your staff.
Anytime I ever had any
question, they would
answer it or find the
answer and get back to
me right away. I am here
to tell your students that
after their one week
didactic course, NIFA is
still there for them when
they walk out those
NIFA doors.”
Donna Howerton
RN, BSN, CNOR ® , RNFA
“I love the convenience
of your course.
It is great for nurses with
tight schedules. I have
retained more from your
style of distance learning,
study guides and
anatomy lessons than
any university course I
have ever attended and I
can’t wait for the six-day
classroom and lab.”
Cheryl Nygren
RN, BSN, CNOR ® , CRNFA ®
A contributing writer for:
Alexander’s Care Of The
Patient In Surgery and
Perioperative Nursing
Care Planning
Jennifer Curran RN, CNOR, RNFA, CRNFA
RNFA Program Director/ Perioperative Division
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P L A N N I N G F O R Y O U R F U T U R E
Comprehensive training for the hands, eyes and mind.
RNFA Program Overview
Your steps to a successful RNFA career!
Online RNFA Home Study Program
Our easy to follow, RNFA Online LearningSystem is presented through a collaboration
between NIFA and college accredited nursing programs. It includes eight NIFA
custom workbooks and coursework that focuses on expanded perioperative nursing
concepts for patients experiencing surgical intervention. Not only will you find our
new distance learning software to be extremely user friendly and state-of-the-art, but
all secured exams can be taken online in your own home. Also included are hands-on
labs for home study. Expected hours of studies: 98 for the normal program and 140
hrs. if you enroll in the RNFA program with a CNOR/Prep.
3 Day SutureStarXpress–a Weekend of Surgeries
The SutureStarXpress Workshop is a one-of-a-kind experience. Here you learn the skills
of the nation’s top surgeons and RNFAs. While others may open books at class, you will
be opening simulated patients and performing actual simulated surgeries cut to close. In
the next few pages you will see the NIFA difference and why so many students choose
this program. The goal is to completely understand the rhythm of surgery. Remember,
this is more than a weekend of just wound closure; you’ll be performing complete surgeries,
- not only as the RNFA, but also as the surgeon. A common question is “Should
I schedule my Workshop only after all my hours of home studies are done” That
would be the best case scenario and is strongly encouraged. However, if you can’t, we
have made concessions so that a student may attend a Workshop while still concurrently
working on their home studies. At the end of the Workshop, NIFA will give you
access to all you’ve learned through review videos online to keep the information fresh.
Supervised Clinical Internship
Once you successfully complete the SutureStarXpress Workshop and all your
coursework, you are ready for your supervised clinical internship. This is 120 hours of
first assisting experience that you log at your own hospital. You will need a surgeon(s)
who will be your clinical sponsor(s) and will supervise your internship. This program is
a surgeon/student dominant model - meaning you only need a surgeon(s) to sign a
sponsor form taking responsibility for your actions during your clinical cases. The program
does not require an agreement with facilities. However, if a training agreement is
requested, we can arrange one at no charge (any attempts past two will be charged a
nominal fee). So, find your surgeon(s) and facilities today and get ready to go!
Your formal RNFA Status recognized in all 50 States
Upon completion of the program, you will receive a Certificate of Completion that
awards you official RNFA status in all 50 states. Since, this program has been accepted
by the Competency Credentialing Institute, (CCI) since 1998, qualified graduates may
sit for the CRNFA or Certified Registered Nurse First Assistant title. Visit www.ccinstitute.org.
Though CRNFA is preferred RNAS-Certification (www.nascouncil.org)
is available for perioperative and NPs graduates who may not yet qualify for CRNFA.
Always adhere to your State's scope of practice issues when performing in the RNFA role.
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Who qualifies to enroll
AD, BSN, Advanced Practice Registerd
Nurses (APRN) from accredited programs. Call.
Have completed a minimum of 2 years
(2,400 hours) of experience in perioperative
nursing, with a minimum of 50% (1,200
hours) in the intraoperative setting
Must be CNOR ® or CNOR ® eligible.
Must obtain CNOR ® before graduating
(waived for NPs). L & D who perform in C
Sections may be CNOR eligible. Call.
Licensed in the state where you will be
logging your clinical internship.
Have your own Malpractice Insurance Policy
that covers you during the RNFA internship.
BLS/ACLS preferred.
Must be current during clinical internship.
Two letters of recommendation from
surgeons.
Perioperative Nurses:
Do you still need CNOR
If you need CNOR, enroll in the program
with our CNOR Prep where you do both concurrently.
Call us about our ‘Pass guarantee.’
Employers are looking
for NIFA students and
graduates exclusively:
“In October of 2010 I enrolled in the
NIFA program. I revised my resume in
November and put it online and my phone
rang off the hook for two weeks because
they wanted NIFA graduates… I got the
job I wanted immediately…I took it down
(resume post) …they still call (employers
wanting NIFA students and graduates).”
Kristi Anderson SutureStar Summit Student
Program awards 159 CEs (201 if you enroll in
CNOR Prep). NIFA is a licensed Provider approved
by the California Board of Registered Nursing,
Provider Number CEP11471.

P L A N N I N G F O R Y O U R F U T U R E
Develop Wound Closure Skills At Home
Start With Our Suture & Tying
Practice Lab for Home Study
When you enroll, you will immediately receive NIFA’s acclaimed
Suture& Tying Workshop for home study. With this powerful workshop
you will develop excellent wound closure skills in your own home, at your
own pace, before attending your SutureStarXpress Workshop.
This uniquely effective online instructional production gives you everything you need
to learn wound closure techniques used by the nation’s top surgeons and RNFAs. You
are going to learn techniques that will make you look and feel like an expert in wound
closure in the comfort of your own home, and at your own pace. Unlike regimented
classroom settings, you will not feel hurried, rushed, or embarrassed in front of
classmates. You can review the presentation as many times as you like until you
perfectly understand every concept and technique that you are studying. So be sure
you take your time and get it right. Along with the online video presentation, NIFA
will provide you with your own Suture & Tying Practice Lab. NIFA’s lab was specially
designed to help you develop the psychomotor skills and hand/eye coordination
surgeons require of well-trained and highly skilled RNFAs.
You will be amazed at how easily and quickly you learn and retain over twenty-three
wound closure skills and techniques from this custom-made surgical lab. The online
presentation and home surgical lab will give you the basis for many of the techniques
you learn at the SutureStarXpress Workshop weekend. A suture and tying Rubric is
provided to help you advance to at least ‘intermediate levels’ before attending the three
day, hands-on, surgical simulation portion of this dynamic training program.
To Enroll 1-800-922-7747
You will learn:
Needle holder – fingers-in technique
Needle holder – palming technique
Forceps – for tissue handling
Forceps – for needle handling
Suture scissors – proper suture cutting technique
Proper needle driving technique
Interrupted simple stitch
Two-handed knot tying – right & left handed
Figure-of-eight stitch
Horizontal mattress stitch
Vertical mattress stitch
First assisting techniques for wound closure
Simple running stitch
Running locking stitch
Running horizontal mattress stitch
Running vertical mattress stitch
Instrument tying technique
Free-tie on a vessel
One-handed knot tying – left & right-handed
The buried knot technique
Multi-layered wound closure technique
Visit www.RNFA.org
First, you’ll receive the best wound closure presentation ever produced!
After registering, you’ll receive our lab within 5 working days:
Online Suture & Tying instructional presentation
including 23 basic to advanced techniques
Suture & Tying Lab and Carrying Case
Needle Holder, Forceps and Scissors as a Bonus Gift!
Knot Tying Trainer
Single and Multi-Layered Abdominal Simulators
Custom Suture and Tying Workbook
Sutures provided by NIFA
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P L A N N I N G F O R Y O U R F U T U R E
Learn Essential Crossover Skill Sets!
Best Route for Your RNFA Career
Receive 34 hours of Simulated Training
You’ll perform cases as the RNFA and the Surgeon!
At the Workshop you will be immersed in surgical cases for three days applying the
skills you learned at home. At the workshop, you will concentrate more on mastering
skills such as palming instruments, how to consistently instrument tie square knots,
how to approximate heavy tissues, suture around vessels, how to follow your surgeons
during a simple running or a running locking stitch, how to deep tie, how to slide a
square knot (every time), how to work with monofilament sutures and how to tie off a
pedicle using a reel or spool. And, you’ll master key techniques in most all specialties.
Altogether, you’ll receive over 34 hours of real training for real results! During all three
days you will be performing actual surgical procedures on simulated human patients.
Animal labs can’t come close to these life-like models in facilitating the skills learning
process. We have re-created the human anatomy with the meticulous detail required to
perform a surgical procedure step-by-step. You can take your time and master your
new skills in a pressure-free, risk- free learning environment. You will have the time
of your life performing two real surgical procedures each day, one as the RNFA and a
second as the surgeon! Role-playing as the surgeon gives you the surgeon’s unique
perspective and increases your anticipatory skills dramatically. You get to know what a
surgeon needs and expects from a well- trained and skilled RNFA. With the NIFA
training method you can practice your new skills within the same surgical context that
you would use in real-life. This is the most enjoyable and highly engaging way you
could ever master these skills. By the end of class, we guarantee you’ll be performing
like a seasoned expert. You’ll find your new-found skills becoming second nature.
All Specialties Benefit Learning Crossover Skills
Whether your specialty is General, Vascular, Thoracic, OB/GYN, Orthopedics,
Oncology, Neuro, Plastics, Cardiovascular, Urology or Reconstructive surgery - all
successful RNFAs have most of the same Surgical Skill Sets in common. We have
isolated the surgical skills you need to perform in surgery like an experienced and
expert RNFA, regardless of your specialty. These skills are valuable, in fact essential,
and crossover to nearly every surgical specialty and subspecialty! You spend a full three
days performing surgeries that concentrate on these essential crossover Skill Sets so that
you can prepare for a lifetime career as a highly competent and successful RNFA.
“…I really have to tell you that the training I received was
great! It taught me so much. The doctors really love it that
I have so much knowledge. They don't even want to suture
their patients anymore. Also, their patients love the
closures of their incision sites. One doctor even called me
yesterday (he had his patient in the office) and wanted me
to come to his office. The patient stated, ‘That nurse really
is great, I had a ugly scar before and now it is beautiful.’ Now, that was a great feeling!”
Mary Corsi RN, CNOR, RNFA NIFA Graduate
2013 & 2014 Schedule
Atlanta, GA.
SutureStarXpress August 16 – 18, 2013
SutureStarSummit August 19 – 24, 2013
SutureStarXpress January 10 – 12, 2014
SutureStarSummit January 13 – 18, 2014
SutureStarXpress August 15 – 17, 2014
SutureStarSummit August 18 – 23, 2014
Chicago, IL
SutureStarXpress November 8 – 10, 2013
SutureStarSummit November 11 – 16, 2013
SutureStarXpress April 4 – 6, 2014
SutureStarSummit April 7 – 12, 2014
SutureStarXpress November 14 – 16, 2014
SutureStarSummit November 17 – 22, 2014
Dallas, TX
SutureStarXpress September 13 – 15, 2013
SutureStarSummit September 16 – 21, 2013
SutureStarXpress September 12 – 14, 2014
SutureStarSummit September 15 – 20, 2014
Denver, CO
SutureStarXpress December 6 – 8, 2013
SutureStarSummit December 9 – 14, 2013
SutureStarXpress June 6 – 8, 2014
SutureStarSummit June 9 – 14, 2014
Las Vegas, NV
SutureStarXpress January 31 – February 2, 2014
SutureStarSummit February 3 – 8, 2014
SutureStarXpress December 5 – 7, 2014
SutureStarSummit December 8 – 13, 2014
Philadelphia, PA
SutureStarXpress October 11 – 13, 2013
SutureStarSummit October 14 – 19, 2013
SutureStarXpress May 2 – 4, 2014
SutureStarSummit May 5 – 10, 2014
SutureStarXpress October 17 – 19, 2014
SutureStarSummit October 20 – 25, 2014
San Antonio, TX
SutureStarXpress March 7 – 9, 2014
SutureStarSummit March 10 – 15, 2014
San Diego, CA
SutureStarXpress July 18 – 20, 2014
SutureStarSummit July 21 – 26, 2014
5

Friday
You will learn:
P L A N N I N G F O R Y O U R F U T U R E
Day One - 32 New Techniques
The first full procedure you’ll perform is a Total Abdominal Hysterectomy. Like the
other procedures we’ve chosen, you will learn many crossover surgical skills and techniques
with this case. You will also be required to apply many of the techniques you
learned on your 14 hour Suture & Tying Lab for home study. TAH day teaches
you how to handle heavy, viable tissues (Ortho students will appreciate this) and how to
suture around vessels as well as the importance of doing so effectively. You will
also learn surgeon’s throws and start mastering two handed knot tying techniques.
Inevitably, your surgeon may request that you tie two handed at some point, no
matter what your specialty. This day also gets you more involved in an all important
technique: the running locking stitch. Following your surgeon during this technique
is an underrated skill but so important to the flow of any procedure.
One NIFA Graduate’s Email to a Colleague:
“Let me start by telling you a bit of
my past adventures of being a nurse.
I started in trauma step down and
went to labor and delivery from there.
I loved labor but noticed that when
my patients had to have a C-Section
my heart jumped a bit. This is
where I learned that the OR was my
destiny... A good friend of mine let
me in on the NIFA program and it
was the best career move that I have made. Not only did I get into the OR as I dreamed but
NIFA prepared me so that I felt completely confident in what I was doing and because of
that same education was able to impress my physicians. The program was very easy to follow
and there was always help if I needed it. The (time) that you spend with NIFA is one that
you will remember for the rest of your life...The best part of this program is that I am doing
what I absolutely love and have received a huge amount of respect that I never dreamed
possible from the physicians and fellow OR staff. I wish you the best in your future
endeavors and know that you will truly be happy with the decision of going with NIFA.”
Sincerely,
Mari Wells RN, CNOR, RNFA
“I felt I learned a lot from your program... The clinical instructions and demonstrations
from Jennifer Curran were excellent…the students were given the opportunity to discuss
any question that came up. Thanks again!
I have had a wonderful learning experience with my home studies and the first assistant
workbooks are great. I have learned a great deal at the first assistant workshop, not only
from the wonderful instructor, who is very, very good but also from the other students and
listening to what goes on at their place of practice.”
Christopher T. Martell RN, BSN, CNOR
Making a Pfannenstiel incision
Determining the incision landmarks
Proper use of the scalpel
Identifying abdominal wall layers
Providing wound layer exposure
Proper use of the scissors and forceps
Sharp dissecting technique
Creating planes between tissues
Entering the abdominal cavity – without injuring the
underlying viscera
Placing the self-retaining retractor – without injuring the
viscera or restricting blood supply to the wound edges
Providing exposure to the operative site
Identifying the uterus and surrounding structures
Uterine manipulation techniques
How to limit excess motion and avoid switching hands to
accomplish assisting tasks
Properly using the Heaney needle driver
Transfixation stitch
Two-handed deep tying – right and left- handed, tying
with one hand and pushing with the other
Tying behind a clamp when the tip is pointed away
from you
Surgeon’s knot
Making a window in tissue to isolate the vascular pedicle
Double clamping and cutting tissue – spooning technique
Heaney stitch
Tie on a pass
Modified Heaney stitch
Smoothly transferring instruments and suture strands
between the operators
Blunt dissecting technique
Safely clamping into tissue – without making a window
Simple stick-ties
Anchor stitch
Running locking stitch – whip stitch for hemostasis
Following the stitch
Burying the knot on the skin stitch is as deep as possible
and away from the apex
6

Saturday
You will learn:
P L A N N I N G F O R Y O U R F U T U R E
Day Two - 13 New RNFA Skills!
Today you and the other students are in to the rhythm of surgery! You will be called
upon to utilize your new surgical skills by performing an Abdominal Aortic Aneurysm
(AAA) Repair. Many surgeons will agree that a poor assistant can make even a great
surgeon look bad. You will learn many tricks to consistently move the case along and
become an asset to your surgeon and patient. Discover how the RN First Assistant
efficiently works in a deep cavity; how to deep tie; and; how to work with monofilament
suture effectively. You will also learn advanced techniques such as palming and
suturing without handling your needle with tissue forceps (unnecessary steps costs
your surgeon, patient and you valuable time). And then, it’s running and following
delicate monofilament sutures, keeping the proper tension, and keeping your
cross clamp time to a minimum.
Optional: EVH Workshop
Endoscopic Vessel Harvesting (EVH) workshop using the
VasoView 6 system with Landmark Identification, Blunt
dissection, Harvesting tricks and secrets - and much more.
Cross-clamping major vessels
Incising major vessels
Figure-of-eight stitches for hemostasis
Needle driving technique in very deep tissues
Vascular anastomosis suturing technique - Parachute
Keeping the knot on the outside of the anastomosis
Providing exposure when suturing the graft
Providing exposure when suturing the vessel
Tying with monofilament suture
Suturing technique that avoids prying up plaque and
creating an embolism
Repairing leaks using pledgets – the plug technique
Repairing leaks using pledgets – the bolster technique
Backhanded suturing technique
Optional: C-Section Workshop
Ceasarean Section delivery is performed in 22.9% of all
births. Each student will perform all the steps from initial
incision through closure of the Pfannenstiel wound.
Optional: Lap Chole Workshop
All NIFA 3 Day students may take advantage of attending
a Lap Chole workshop at one of our 6 day Summit classes
once at a future date (no charge). Each student will perform
trocar placement, cystic duct and cystic artery clipping
(etc.) moving on to the end of the case.
Optional: Carotid Endarterectomy
Workshop
This surgery’s purpose is to remove plaque buildup in the
carotid arteries and proven to be 3 times more effective
than treatment with medicine alone in preventing stroke.
Optional Workshop Notice:
All NIFA 3-day students may take advantage of attending
one or more of the above workshops held during one of
our scheduled 6 Day SutureStar Summits throughout the
country. Regular registrations are $295 for each class, but
only $95 for existing NIFA students (Lap classes no
charge). Call for availability and dates. To take advantage of
this discounted offer, you must attend your optional workshop(s)
while a student or within one year after graduation.
“This was a truly wonderful educational
experience! I gained a wealth of knowledge
in order to assist the surgeon with the
operation.”
Kaye Linde RN, CNOR ®
Which should I attend, a
3 Day or 6 Day Workshop
The answer depends on your level of experience
and in many cases time and funds. The 6 day
workshop basically has twice the suturing of the
3 day workshop and gives students more time to
assimilate their new found skills. The 6 day
Workshop is mandatory for new NPs and also
strongly recommended for new periop nurses.
NIFA is the only program with
RNFA specific robotic classes.
7

Sunday
You will learn:
P L A N N I N G F O R Y O U R F U T U R E
Day Three - Learn Another 17 New
RNFA Crossover Skills!
Today, you will perform a Transverse Colon Resection without staplers. You’ll get the
chance to utilize a lot of one handed sliding square knots. As a matter of fact, between
the RN First Assistant and the surgeon roles, you’ll be placing at least 60 sliders.
This lab is stitch placement intensive. You will have to place concise, delicate stitches
(approximately 3-4 millimeters apart) and learn how to use fine taper needles to your
benefit. Balancing tissue is vital in all specialties so be assured you will use these skills
in everyday practice. This day is also rich in one handed tying techniques. Altogether,
you will be throwing at least 300 throws of one handed sutures to help you develop
the muscle memory required to perform consistently in your RNFA internship. Your
surgeon preceptor will thank you for that! Once again, you will be working on mastering
the intricacies of sliding square knots. All specialties need to know how to throw a
sliding square knot in a closure whether they work in General, Ortho, Plastics,
Neurosurgery, ENT - you name it.
Keeping scissors at the ready while
dissecting with another clamp
Sliding square knots
Organizing multiple clamps
One-hand tying for speed – tips of clamps facing
you, left handed
Clamp flashing and removal – left handed
Sharp dissection of tissue away from around the
resection site
Clamping and cutting the bowel
One-handed tying – tying with one hand and pushing
with the other
Dissection of mesocolon
You’ve come to the end of the SutureStarXpress Workshop Weekend. If your coursework
is done, you have now been properly prepared to start your RNFA internship!
5 easy steps to a RNFA career today!
1 Call us at 1-800-922-7747 (Mon.-Thurs. 7:30am-5pm, Fri. 7:30am-4pm
MST) to have all your questions thoroughly answered and to enroll over the
phone. To expedite the process, you can fax us your Enrollment Form.
2 Your Suture & Tying Practice Lab will be shipped out via UPS the following
Monday and the Education Department will begin processing you
officially in the online program. You can expect to be completely set up with
your online studies within three to four working days.
3 Schedule a SutureStarXpress Workshop date and start your Online program
immediately to complete as much coursework as possible before class! Note:
Workshops fill quickly, so call your counselor about available dates before
attempting to schedule time off work.
4 After completing the SutureStarXpress Workshop and all required course
work, you may start your 120 hour internship with your designated
sponsoring surgeon(s). NOTE: Because of our intensive hands-on
curriculum, NIFA students ‘cruise’ during their RNFA clinical internshipls.
5 Congratulations! When you have completed the entire program you will
receive a Certification of Completion from NIFA and the college designating
your formal RNFA status, meeting AORN standards, recognized in all 50
states and awarding college credits along with surgical CEs (note: hours can
be used towards CNOR and CRNFA).
Deep tying a vessel simultaneously with the surgeon
Large bowel anastomosis
How best to assist during anastomosis
Following suture while maintaining exposure
Making a secure closure of the apex
Lembert stitch - (serosal stitch)
Connell stitch - (mucosal stitch)
Repairing an internal hernia
Newest AORN 2012
Salary Survey Shows:
“ RNFAs received the largest compensation
relative to base pay…”
“ The employees most likely to receive a
hiring bonus are... RNFAs…”
Call NIFA for RNFA Employment.
To Enroll:
1-800-922-7747
NIFA, 12354 E. Caley Ave Ste 108,
Centennial CO 80111
rnfa@nifa.com